ALCOHOL 

AND---—— 

PROHIBITION 

FROM  THE 

STANDPOINT 
OF  MODERN 
SCIENTIFIC 
MEDICINE 


ARTHUR  DEAN  BEVAN,  M.  D. 
Professor  of  Surgery  Rush  Medical  College 
Surgeon  Presbyterian  Hospital Former 
‘President  cAmerican  Medical  Ass’n 


THE  ANTI-SALOON  LEAGUE  OF  AMERICA 
WESTERVILLE.  OHIO 


Digitized  by  the  Internet  Archive 
in  2017  with  funding  from 
Columbia  University  Libraries 


https://archive.org/details/alcoholprohibitiOObeva 


ALCOHOL  AND  PROHIBITION 
FROM  THE  STANDPOINT  OF 
MODERN  SCIENTIFIC  MEDICINE 

By  ARTHUR  DEAN  BBVAN,  M.D. 

PKOrESSOR  OT  SURGERYj  RUSH  MEDICAL  COLLEGE  ; 
SURGEON  THE  PRESBYTERIAN  HOSPITAL;  FORMER 
PRESIDENT  OF  THE  CHICAGO  MEDICAL  SOCIETY  I 
FORMER  PRESIDENT  OF  THE  AMERICAN  MEDICAL 
ASSOCIATION^  ETC.* 

ALCOHOL  FROM  THE  STANDPOINT 
OF  MODERN  SCIENTIFIC  MEDICINE 

HOR  many  centuries  man  has 
consumed  various  kinds  of  al- 
coholic drinks.  The  amount  of 
alcohol  in  these  drinks  has  va- 
ried greatly.  They  can,  how- 
ever, be  divided  into  three  gen- 
eral groups:  Beer,  containing  from  2 to 
4 per  cent  of  alcohol;  Wine,  containing 
from  10  to  20  per  cent;  and  strong  liquors, 
like  whisky,  rum  and  gin,  containing  from 
40  to  50  per  cent. 

Viewed  from  the  standpoint  of  modem 
scientific  medicine  alcohol  belongs  to  the 
group  of  narcotics  which  consist  of  al- 
cohol, ether,  chloroform,  chloral  and 
similar  drugs,  such  as  sulphonal  and 
veronal.  The  general  actions  of  all  the 
members  of  this  narcotic  group  are  very 
much  the  same.  They  produce  a first 
stage  of  imperfect  consciousness  and  con- 
fused ideas,  followed  later  by  a stage  of 
excitement,  and  if  the  dose  is  large  com- 
plete unconsciousness  which  may,  if  the 
dose  is  suflBciently  large,  terminate  in 
death.  A fatal  dose  varies  from  a pint 
to  a quart  of  alcohol  consumed  within  a 
few  hours. 

♦Address  delivered  before  State  Convention  of 
IllinoiB  Anti-Saloon  League,  Dec.  20,  1S2S. 

[3] 


DIRECT  INJURIOUS  ACTION  ON 
THE  BRAIN 

There  has  been  some  dispute  as  to 
whether  these  drugs  are  stimulants  or  are 
paralyzing  agents.  Scientific  men  who 
have  studied  this  problem  for  the  most 
part  regard  them  as  not  being  stimulants 
at  all,  or  if  they  have  a stimulating  action, 
the  stimulating  action  is  very  temporary 
as  the  main  action  is  that  of  depressing 
agents.  All  of  these  narcotics  have  a 
special  afBnity  for  fatty  tissues  and  the 
nervous  system  and  are  carried,  after 
being  absorbed  in  the  body,  by  the  blood 
to  the  brain  where  the  nerve  cells  are 
rich  in  fatty  substances,  called  lipoids. 
Alcohol  produces  a direct  injurious  effect 
upon  the  brain. 

EFFECT  ON  NERVOUS  SYSTEM 

The  action  of  alcohol  on  the  nervous 
system  differs  a good  deal  in  different  in- 
dividuals. In  small  amounts  it  produces 
a feeling  of  greater  confidence  in  the 
mental  and  physical  powers  of  the  in- 
dividual who  may  become  boisterous  and 
loquacious;  self  control  Is  lost  and  the 
will-power  is  weakened.  The  individual 
may  seem  to  be  unusually  clever  for  a 
time  and  then  the  speech  becomes  difB- 
cult,  the  gait  unsteady,  and  this  may 
be  followed  by  nausea  and  vomiting. 
Large  doses  of  alcohol  may  produce  very 
deep  sleep  which  may  pass  into  such  com- 
plete unconsciousness  as  to  resemble  the 
condition  of  ether  or  chloroform  anes- 
thesia, and  this  condition  may  last  for 
hours,  and  eventually  result  in  death. 

Carefully  planned  experiments  show 
that  regiments  of  troops  can  march  fur- 
ther and  are  in  better  condition  after  se- 
vere exercise  without  alcohol  than  those 
[4] 


that  are  supplied  with  alcohol.  In  doing 
Intellectual  work  it  has  heen  found  that 
the  receptive  and  intellectual  powers  are 
weakened  by  very  small  quantities  of  al- 
cohol. This  has  been  tested  out  with 
people  setting  up  type  and  with  people 
adding  up  columns  of  figures,  and  in  a 
variety  of  ways. 

EFFECT  ON  DIGESTION 

The  effects  of  alcohol  on  digestion  have 
been  extensively  studied.  Its  continued 
use  in  considerable  quantities  produces 
chronic  irritation  of  the  stomach,  a gas- 
tric catarrh,  with  resulting  nausea  and 
vomiting.  It  has  often  been  claimed  that 
alcohol  is  of  value  as  a food.  It  is  true 
that  a small  amount  of  alcohol  can  be 
burned  up  in  the  body  Just  as  starches, 
fats  and  sugars  can  be  burned  up.  The 
amount  that  can  be  safely  used  as  a 
food,  however,  is  very  limited,  as  even  in 
comparatively  small  amounts  alcohol  has 
a definite  deleterious  effect  upon  the  ner- 
vous system.  Continued  use  of  alcohol 
produces  fatty  degeneration  of  the  heart 
and  other  tissues.  It  produces  arterio- 
sclerosis of  the  blood  vessels  and  cirrhosis 
of  the  liver.  For  many  years  alcohol  was 
prescribed  in  cases  where  individuals  were 
suffering  from  different  forms  of  infection. 
Modern  scientific  medicine  has  shown  that 
alcohol  does  not  assist  the  body  in  re- 
sisting infections  but  that  it  makes  the 
individual  much  more  susceptible  to  in- 
fections. This  is  particularly  true  in 
pneumonia,  where  careful  observation  has 
shown  that  the  individual  who  drinks 
even  moderately  becomes  much  more 
easily  the  victim  of  pneumonia  than  the 
man  who  does  not  drink  at  all. 

15] 


AS  A THERAPEUTIC  AGENT 

Alcohol  has  little  place  In  modem 
scientific  medicine  as  a therapeutic 
agent.  At  the  Presbyterian  Hospital  in 
Chicago,  where  we  take  care  of  more 
than  twelve  thousand  patients  a year,  we 
have  not  yet  prescribed  through  the  drug 
room  of  the  hospital  a single  bottle  of  al- 
coholic liquor  since  the  passage  of  the 
prohibition  amendment,  and  this  is  not 
due  to  any  regulation  against  the  use  of 
alcohol.  Any  one  of  the  attending  medi- 
cal men  has  the  privilege  of  using  alcohol 
if  he  sees  fit  in  the  handling  of  his  cases. 
It  is  due  to  the  fact  that  there  is  little 
or  no  logical  or  scientific  reason  for  the 
internal  administration  of  alcohol  in  the 
modern  treatment  of  disease.  On  the 
other  hand,  the  external  use  of  alcohol 
has  increased  very  markedly.  We  use 
hundreds  of  gallons  of  denatured  alcohol 
which  costs,  without  the  internal  revenue 
tax,  from  40  to  53  cents  a gallon,  in 
alcohol  rubs  for  patients,  in  making 
tincture  of  green  soap  which  is  very  ex- 
tensively employed  in  cleansing  wounds 
and  preparing  fields  of  operation,  and 
we  use  seventy  per  cent  of  denatured  al- 
cohol as  the  best  method  of  sterilizing 
fields  of  operation,  the  hands  of  the  sur- 
geon, the  assistants  and  nurses,  in  at- 
tempting to  secure  an  aseptic  field.  The 
exposure  for  ninety  seconds  of  any  germs 
which  produce  suppuration  to  a seventy 
per  cent  solution  of  alcohol  produces 
death  of  all  of  these  germs. 

THE  ABUSE  OF  PRESCRIPTION 
WHISKY 

Alcohol  is  no  longer  used  by  scientific 
physicians  in  acute  Infiammatory  dis- 
eases, such  as  pneumonia  and  grippe.  It 
is  not  only  not  beneficial  but  definitely 

[6] 


harmful  in  tueh  aondltioiu.  It  is  no 
longer  used  in  septic  conditions.  Its  only 
use,  outside  of  its  external  use,  in  modern 
scientific  medicine  is  found  in  cases  of 
Individuals  who  are  chronic  users  of  al- 
cohol and  who  are  brought  to  the  hos- 
pital suffering  from  some  accident  or 
some  disease  in  which  a moderate  amount 
of  alcohol  is  continued  for  a time  in  or- 
der to  prevent  the  development  of  de- 
lirium tremens. 

It,  of  course,  has  been  a matter  of 
common  knowledge  that  the  prescribing 
of  whisky  by  physicians  since  the  passage 
of  the  prohibition  amendment  has  been 
grossly  abused.  I think  very  few  of  us 
realize  how  gross  this  abuse  really  has 
been  and  what  a disgraceful  situation  has 
been  brought  about  by  the  provisions  of 
the  prohibition  amendment  for  the  pre- 
scribing of  whisky.  I have  taken  pains 
to  investigate  this  matter  with  a good 
deal  of  care,  and  desire  to  submit  to  you 
some  of  the  important  results  of  that  in- 
vestigation. The  figures  which  I shall 
present  to  you  are  accurate  in  the  sense 
that  they  give  a correct  picture  of  the 
situation  in  gross  figures. 

Year  before  last  there  was  issued  from 
the  government  warehouses  a total  of 
1,800,000  gallons  of  hard  liquor.  This  was 
almost  entirely  whisky.  Approximately 
ninety  per  cent  of  this  was  issued  on 
physicians’  prescriptions.  This  would 
make  1,620,000  gallons — there  are  eight 
pints  in  a gallon — making  approximately 
13,000,000  pints.  At  $3.00  a pint,  which 
is  the  ordinary  price  obtained  by  physi- 
cians for  these  prescriptions,  the  total 
amount  of  money  received  by  the  medical 
profession  (all  of  these  prescriptions  paid 
for  at  that  rate)  would  be  about  $39,000,- 
000.  I desire  to  emphasize  this  point 

171 


showing  the  enormous  possibility  of  graft 
Involved  in  this  situation. 

GRAFT  IN  PRESCRIPTION  WHISKY 

I desire  to  submit  two  main  facts: 

First — That  there  is  an  enormous 
amount  of  graft,  probably  in  the  neigh- 
borhood of  $40,000,000  in  the  writing  of 
prescriptions  by  the  medical  profession 
for  whisky. 

The  second  point  I desire  to  make  Is 
that  in  the  modern  scientific  practice  of 
medicine  there  are  very  few  cases  in 
which  whisky  can  be  properly  and  scien- 
tifically employed  as  a medical  agent. 

My  experience  in  the  practice  of  medi- 
cine in  Chicago  covers  the  period  from 
1894  to  date.  I have  never  had  any  fixed 
opposition  to  the  use  of  whisky  in  medi- 
cal practice,  but  I have  never  employed 
it,  or  seen  it  properly  employed,  except 
in  just  such  cases  that  I have  cited.  My 
very  considerable  experience  in  the  prac- 
tice of  medicine  can  not  have  been  so 
very  different  from  those  of  other  men 
in  the  medical  profession. 

DISHONEST  PRESCRIPTIONS 

Before  the  days  of  prohibition  no 
honest  doctor  ever  prescribed  100  pints  of 
whisky  to  his  patients  in  a few  months; 
as  certainly  today  no  honest  doctor  ever 
prescribes  100  pints  of  whisky  every  three 
months,  or  to  make  it  more  emphatic,  no 
honest  physician  ever  prescribed  400  pints 
of  whisky  to  his  patients  a year.  The  Pro- 
hibition Administrator  in  this  district  In- 
forms me  that  approximately  90  per  cent 
of  the  physicians  who  have  been  issued 
prescription  books  regularly  prescribe 
their  full  allotment  of  100  prescriptions 
every  three  months.  Almost  all  of  these 
prescriptions  are  bootlegging  prescrip- 
[8] 


tlons.  Very  few  of  them  are  bona  fide 
scientific  medical  prescriptions. 

DISGRACE  TO  MEDICAL 
PROFESSION 

There  can  be  but  one  meaning  to  this 
situation.  The  man  on  the  street  knows 
what  that  meaning  is;  the  public,  gener- 
ally, know  what  this  situation  means.  It 
can  mean  but  one  thing,  that  the  men 
who  are  prescribing  and  selling  100  pre- 
scriptions every  three  months,  their  full 
allotment,  are  a disgrace  to  the  medical 
profession. 

It  is  obvious  that  the  existing  state  of 
facts  carries  with  it  an  enormous  abuse 
of  this  whisky  prescribing.  It  is  clearly 
the  duty  of  the  organized  medical  profes- 
sion of  this  country  to  do  everything  in 
their  power  to  secure  such  change  in  the 
government  regulations  as  will  make  it 
impossible  for  the  bootlegging  members 
of  the  profession  to  continue  their 
present  practices. 

In  regard  to  the  habitual  use  of  al- 
cohol by  healthy  persons  all  authorities 
agree  that  it  is  a luxury,  that  it  is  un- 
necessary for  the  growth  and  maintenance 
of  the  body  and  that  it  neither  promotes 
greater  healthfulness,  nor  in  any  way 
retards  the  onset  of  disease. 

BAD  EFFECTS  OF  ABUSE  OF 
ALCOHOL 

The  bad  effects  of  the  abuse  of  alcohol 
can  be  seen  in  hospitals,  prisons  and 
asylums  of  all  countries,  especially  those 
where  the  population  is  addicted  to 
spirits.  A large  percentage  of  crime  is 
admittedly  done  under  the  influence  of 
alcohol.  Alcohol  is  responsible  for  a large 
part  of  the  poverty  and  misery  of  the 
lower  classes  of  the  population.  Many 
of  the  admissions  to  lunatic  asylums  are 
[9] 


due  to  aleohol.  It  would  not  be  sua  exag- 
geration to  say  that  drink  has  done  more 
injury  to  mankind  than  has  been  done 
by  such  great  plagues  as  cancer  and 
tuberculosis  combined.  It  is  responsible 
for  a large  portion  of  the  venereal  dis- 
eases that  occur.  The  facts  which  I have 
presented  above  are  not  merely  my  im- 
pressions, they  are  taken  from  the  text- 
books of  the  best  authorities  on  pharma- 
cology, the  science  of  the  action  of  drugs. 

need  for  prohibition 

In  view  of  these  scientific  facts  if  a 
nation  could  by  legislation  eliminate  the 
curse  of  drink,  with  its  resulting  misery 
and  death,  legislation  to  that  effect 
should  be  passed  over  night  and  rigidly 
enforced.  Fortunately,  in  this  country 
such  legislation  has  been  passed.  It  has 
been  fairly  well  enforced;  not  as  effective- 
ly as  it  can  be  enforced  in  the  future,  but 
it  has  been  sufficiently  well  enforced  to 
have  made  a wonderful  improvement  in 
the  health  and  well-being  of  our  people 
as  a whole.  In  some  states  it  has  been 
much  more  effectively  enforced  than  in 
others. 

REDUCTION  IN  BEER  CONSUMPTION 

There  has  been  a great  diminution  in 
the  amount  of  alcohol  consumed  by  the 
people  of  this  country  since  the  passage 
of  prohibition.  The  consumption  of  beer 
has  been  almost  entirely  eliminated.  Ac- 
curate statistics  properly  accumulated 
would  show  probably  that  less  than  five 
or  possibly  less  than  three  per  cent  of 
the  amount  of  beer  is  consumed  in  the 
United  States  that  v/as  consumed  in  the 
old  pre-war  days.  The  total  amount  of 
alcohol  consumed  in  drink  is  probably 
less  than  ten  per  cent  of  the  amount  that 
was  consumed  in  the  pre-war  days. 

[10] 


The  cMdlsh  chatter  of  many  indiTldu- 
als  who  are  opposed  to  prohibition  that 
there  is  more  liquor  in  the  country  today 
than  ever  before  can  easily  be  shown  to 
be  untrue.  The  arguments  of  those  who 
are  opposed  to  prohibition  that  everybody 
is  drinking  and  that  everybody  is  making 
beer  and  moonshine  can  easily  be  con- 
troverted by  a careful  analysis  of  the 
facts.  The  opposition  to  prohibition  has 
become  with  some  men  a fixed  idea,  an 
obsession  which  makes  it  impossible  for 
them  to  treat  the  problem  fairly  or  in- 
telligently. 

SURVEY  NEEDED 

One  of  the  most  important  things  that 
can  be  done  at  this  time  would  be  a sur- 
vey, by  the  Federal  government,  of  the 
actual  state  of  facts  in  regard  to  prohi- 
bition throughout  the  country  made  by  a 
properly  qualified  governmental  body 
with  ample  facilities  to  do  the  work  effec- 
tively, as  is  done  by  the  government  in 
estimating  the  amount  of  the  wheat  crop 
or  cotton  crop  of  the  country.  The  facts 
in  regard  to  prohibition  could  probably 
be  quite  as  accurately  estimated  as  the 
amount  of  wheat  or  cotton  raised,  and  for 
years  such  government  estimates  have 
been  in  close  keeping  with  the  actual 
amounts  produced. 

A GREAT  SUCCESS 

Taking  into  consideration  the  fact  that 
drink  has  been  an  almost  universal  and 
centuries-old  habit  of  the  human  race, 
the  results  secured  by  prohibition  in  this 
country  in  the  last  nine  years  must  be 
accepted  as  a great  success  for  this  move- 
ment. 

In  wiping  out  a great  curse  like  drink 
or  like  slavery  it  is  to  be  expected  that 
such  an  effort  would  meet  with  serious 
[ 11  ] 


opposition  and  that  success  can  only  be 
secured  after  years  of  effort.  This  was 
true  of  slavery  and  it  will  be  true  of 
drink. 

Fortunately  for  the  United  States  the 
Eighteenth  Amendment  is  now  a part  of 
our  Constitution.  It  can  not  be  repealed 
except  by  the  con-joint  action  of  at  least 
36  states.  No  legislation  by  Congress  can 
so  modify  the  definition  of  intoxicating 
liquors  as  to  permit  the  manufacture, 
sale  and  transportation  of  liquors  that 
are  in  fact  Intoxicating. 

The  question  as  to  whether  a liquor  is 
intoxicating  or  not  is  not  a matter  of 
scientific  medical  opinion  at  all  but  is  a 
matter  of  common  knowledge  and  com- 
mon sense.  It  is  a matter  of  common 
knowledge  that  a man  could  get  drunk  on 
the  old  beer  that  was  manufactured  be- 
fore prohibition  which  contained  from  3 
to  4 per  cent  of  alcohol,  and  it  is  a mat- 
ter of  common  sense  that  if  a man  can 
get  drunk  on  such  beer  he  can  get  drunk 
on  beer  containing  2.75  per  cent  of  alco- 
hol by  drinking  a few  more  glasses  or  a 
few  more  bottles. 

MUST  BE  CONTINUED 

We  are,  therefore,  in  a position  where 
our  experiment  with  prohibition  must  be 
continued  for  a number  of  years.  The 
experiment  should  be  continued  in  a logi- 
cal, orderly,  scientific  way.  The  Eight- 
eenth Amendment  should  be  thoroughly 
enforced  in  all  parts  of  the  country  by 
the  Federal,  state  and  municipal  govern- 
ments. If  this  is  done  the  Eighteenth 
Amendment  will  accomplish  more  for  the 
personal  hygiene  and  public  health  of  the 
people  of  this  country  than  any  legisla- 
tion ever  passed. 

One  of  the  most  Important  steps  that 
can  be  taken  in  this  experiment  at  this 
[ 12  1 


time,  when  there  is  a great  deal  of  con- 
troversy over  the  success  or  failure  of  the 
Eighteenth  Amendment,  would  be  the 
appointment  of  the  Federal  body  which  I 
have  already  referred  to,  a body  ap- 
pointed for  the  purpose  of  obtaining  defi- 
nite and  positive  knowledge  as  to  the 
existing  state  of  facts  in  regard  to  the 
amount  of  liquor  consumed  in  this  coun- 
try as  compared  with  the  pre-war  days. 
This  will,  I believe,  show  that  prohibition 
is  even  today  at  least  90  per  cent  success- 
ful in  the  sense  that  it  has  eliminated  90 
per  cent  of  the  alcohol  which  was  for- 
merly consumed  per  capita.  It  is  to  be 
hoped  that  Mr.  Hoover,  who  was  so  over- 
whelmingly endorsed  at  the  recent  elec- 
tion, running  on  a dry  platform,  will  un- 
dertake this  complete  survey  in  order  that 
the  country  may  know  the  true  facts  of 
the  situation. 

The  Eighteenth  Amendment  is  a part 
of  our  Constitution  and  should  be  made 
as  effective  as  possible.  In  the  long  run, 
prohibition  is  bound  to  win  because  every 
man  knows  and  every  woman  knows  that 
they  are  better  off  and  that  the  boys  and 
girls  of  this  country  are  better  off  without 
drink. 


(PRINTED  IN  THE  D.  S.  A.) 


I 13  ] 


